Mountain Comprehensive Care Center (MCCC) is requesting $1,500,000 annually over a 3-year project period to implement the Big Sandy Optimal Health Teen Pregnancy Prevention (TPP) program to improve the optimal health of youth ages 10-19 and to reduce teen pregnancy and sexually transmitted infections through a systems thinking approach that replicates effective TPP and behavioral health programs with fidelity including evidence-based and trauma informed education coupled with a comprehensive array of program specific and community-based services within the rural Big Sandy region of eastern Kentucky: a 1,989 square mile area in Central Appalachia comprised of Floyd, Johnson, Magoffin, Martin and Pike counties.
While the nation continues to see declining teen pregnancy rates, the Big Sandy Region, located in the Central Appalachia region of Kentucky, continues to be stagnant and not declining at the same rate as the rest of the county. Rates for 2015-2017 averaged 46.5 per 1,000 females ages 15-19 with Floyd at 55.9, Johnson 30.3, Magoffin highest at 57.3, Martin at 50.7 and Pike at 38.2 – all of which are higher than Kentucky at 29.7 and more than doubles (228%) the U.S. at 20.4 although rates for the nation have further dropped to 17.4.
The TPP will serve any eligible youth within the service area and will specifically target the following high-risk populations found to have the greatest need and disparities as the Big Sandy region experiences significant health, economic, and social challenges: 1) youth involved in the child welfare system; and 2) youth struggling with behavioral health issues, including mental health and substance use disorders. MCCC anticipates that there are approximately 2,400 youth who fit into one or both of the proposed populations of focus within the service area, with 600 required to be served on an annual basis and 1,800 served over the life of the grant through replication of an effective program, and all likely to receive at least one or more supportive services. These robust service numbers will be accomplished through utilizing community partnerships and an appropriate number of TPP staff to provide culturally and age appropriate, medically accurate, and trauma-informed effective programs. Population numbers will be updated as new community and program level data is available to ensure a saturation of at least 25% of the population of focus on a continuous basis.
This grant would allow MCCC to utilize multiple leverage points to saturate the Big Sandy region with effective programs and supportive services focused on changing individual attitudes, efficacy, and behaviors, as well as improving community-level knowledge and attitudes. As such, MCCC has determined that it will: 1) Implement direct TPP services, including: mental health and substance abuse counseling/therapy, peer mentoring, case management, family strengthening, and building social/emotional capital in youth inclusive of youth-led strategies with the express purpose of improving the optimal health of youth within the TAG framework; 2) Provide TPP education (Reducing the Risk) throughout the service area to reduce teen pregnancy and sexually transmitted infections through a systems thinking approach that replicates EBPs and trauma informed programs with fidelity; 3) Deliver TPP education training opportunities for program education partners; and 4) Oversee the TPP Advisory Council compromised of community partners, youth participants and their families to ensure the TPP incorporates input from youth, parents/caregivers, and the community throughout the planning, implementation and evaluation of the project to drive a responsive and transformative project that best meets the needs of the population and to implement a CQI plan with fidelity.